Ukushisa ngokweqile ingenye yezinkinga ezivame kakhulu futhi ezinzima kakhulu phakathi nokukhulelwa. Kungenye yezibonakaliso ze-pre-eclampsia - isimo esimweni esinzima esiholela ekufeni komama, kanye nokwephulwa kokuthuthukiswa komntwana kanye nokuzalwa ngaphambi kwesikhathi. Ukubona izibonakaliso zokuqala ze-preeclampsia kungasindisa impilo yomfazi.
Izinhlobo ze-high blood pressure ekukhulelwe
I-pre-eclampsia nezinye izimo, ezihambisana nokwanda kwegazi, zitholakala cishe ngo-10% we-primipara. Kodwa-ke, kulabo besifazane abaningi abakhulelwe, ukushisa komfutho wegazi akubangele ukukhathazeka okuphawulekayo, ngaphandle kokuthi kufanele bahlolwe ngokwezokwelapha ekupheleni kokukhulelwa.
Kunezinhlobo ezintathu eziyinhloko zomshukela okhukhulayo kwabesifazane abakhulelwe:
- isifo sofuba esandulele-sikhombisa ukukhulelwa okwenzeka ngokuvamile; ngezinye izikhathi ukwanda kwengcindezi yegazi kuqala ukuxilongwa ngesikhathi sokukhulelwa;
- I-hypertension ye-gestational - ivela ngemuva kokukhulelwa. Kulesi simo, akukho protheyini emcimbini, futhi ukucindezeleka kwegazi kubuyela emuva evamile kungakapheli amasonto ayisithupha emva kokubeletha;
- i-pre-eclampsia - ukwanda kwengcindezi yegazi kunomthelela omubi kwezinye izinhlelo zomzimba; ngokuvamile kuhambisana nokubonakala kwamaprotheni emcinini.
I-preeclampsia ingaba nemiphumela emibi engongela impilo yomama ozayo nomntwana. Njengoba ukwanda kwengcindezi yegazi, owesifazane okhulelwe udinga ukwelashwa okuphuthumayo ukuze avimbele ukuthuthukiswa kwe-eclampsia, ehambisana nokuxubana nokuhlaselwa komzimba. Ukutholakala kokuqala kwezibonakaliso kanye nokwelashwa okufika ngesikhathi kungavimbela ukuthuthukiswa kwe-eclampsia. Ngokuvamile kuhambisana nalezi zimpawu ezilandelayo:
- ukubonakala kwezibani zokukhanya, imivimbo, "izimpukane" phambi kwamehlo, ukunyamaza emehlweni;
- i-photophobia;
- ikhanda;
- ubuhlungu esiswini esingenhla noma kwesokudla kwesokudla;
- ukuhlanza;
- i-malaise ejwayelekile.
Njengoba ukwanda kwengcindezi yegazi, kubalulekile ukucacisa imbangela nokuhlola ubunzima be-hypertension. Ukwakhiwa kwezibhedlela ngenxa yalokhu ngokuvamile akudingeki, kodwa ngezinye izikhathi kunesidingo socwaningo olwengeziwe. Kunezici eziningana zokubeka ingozi ekuthuthukiseni i-preeclampsia:
- ukukhulelwa kokuqala;
- ukutholakala kwe-pre-eclampsia ekukhulelweni okudlule;
- uneminyaka engaphansi kuka-20 noma ngaphezulu kuneminyaka engama-35;
- ukukhula okuphansi;
- i-migraine;
- amacala we-preeclampsia noma i-eclampsia kwabesifazane emndenini;
- isifo sofuba esandulele;
- ukungabi nesisindo somzimba;
- ukukhulelwa okuningi;
- Ukutholakala kwezifo eziqhamukayo, njenge-systic lupus, isifo sikashukela kanye nesifo sikaRaynaud.
Kwabesifazane abathile abakhulelwe, izimpawu ezivamile ze-hypertension azikho, futhi ukwanda komfutho wegazi kutholakala kuqala ngokuhlolwa kokulandelayo kokubonisana kwabesifazane. Ngemva kwesikhashana, ukulinganisa okuphindaphindiwe kokucindezelwa kwegazi kwenziwa. Ngokuvamile izinkomba zayo azidluli 140/90 mm Hg. isib., futhi ukwanda okuzinzile kubhekwa njenge-pathology. I-urine iphindwa futhi ngokuhlaziywa ngokuba khona kwamaprotheni ngosizo lwama-reagents akhethekile. Izinga lalo lingachazwa ngokuthi "0", "ukulandelana", "+", "+ +" noma "+ + +". Inkomba "+" noma ngaphezulu ixilongwa ngokuphawulekayo futhi idinga ukuhlolwa okwengeziwe.
Isibhedlela
Uma ingcindezi yegazi ehlala iphezulu, ukuhlolwa okungeziwe ngaphakathi kwesibhedlela kwenziwa ukuze kunqunywe ukuqina kwesifo. Ukuze uthole ukuxilongwa okunembile, isampula yamahora angu-24 nesampula sezinga lamaprotheni senziwa. Ukungaxhunyiwe emcinini wama-300 mg amaprotheni ngosuku kuqinisekisa ukuxilongwa kwe-pre-eclampsia. Kuhlolwa ukuhlolwa kwegazi ukuze kunqunywe ukwakheka kwamaselula kanye nomsebenzi we-renal no-hepatic. Isimo se-fetal sihlolwe ngokuqapha isilinganiso senhliziyo ngesikhathi se-cardiotocography (CTG) nokwenza ukuskena kwe-ultrasound ukuhlola ukuthuthukiswa kwayo, umthamo we-amniotic fluid kanye nokugeleza kwegazi emcimbini we-soppler. Kwabesifazane abathile, ukubhekwa okuningiliziwe kungalungiswa ngaphandle kokuhlala esibhedlela, isibonelo, ukuvakashela esibhedlela sosuku lwesigceme sokubeletha, izikhathi eziningana ngesonto. Amacala amakhulu kakhulu adinga ukunakekelwa esibhedlela ukuze aqaphe amazinga okucindezeleka kwegazi njalo amahora amane, kanye nokuhlela isikhathi sokudiliva. Ukushisa komfutho, okungahlanganiswa ne-preeclampsia, kungagcinwa ne-labetalol, methyldopa ne-nifedipine. Uma kunesidingo, ukwelashwa okunamandla kungenziwa noma nini lapho ukhulelwa. Ngakho-ke, kungenzeka ukuvimbela izinkinga ezinkulu zokukhulelwa. Ngokuthuthukiswa kwe-pre-eclampsia, kungenziwa isifundo esifushane se-antihypertensive therapy, kodwa kuzo zonke izimo, ngaphandle kwamafomu amancane, uhlobo oluyinhloko yokwelashwa ukulethwa kwezidingo. Ngenhlanhla, ezimweni eziningi, preeclampsia iqala ngokukhulelwa kwesikhathi. Ngezimo ezinzima, ukulethwa ngaphambi kwesikhathi (ngokuvamile ngesigaba sokudla) kungenziwa ekuqaleni. Ngemuva kweviki lama-34 lokukhulelwa, umsebenzi wokuzalwa uvame ukuvuselelwa. I-preeclampsia enamandla ingaqhubeka, iphenduke ekuhlaselweni kwe-eclampsia. Kodwa-ke, ziyinto engavamile kakhulu, njengoba iningi labesifazane litholakala ngezigaba ezingenakubalwa.
Ukubuyiselwa kwesifo somfutho wegazi ophezulu uma kwenzeka ukhulelwe ngokuphindaphindiwe
I-preeclampsia ijwayele ukuphindela ekukhulelweni okulandelayo. Izinhlobo ezincane zalesi sifo ziphindaphinda kancane (ngo-5-10% wamacala). Izinga eliphindaphindiwe le-preeclampsia elinamandla liyi-20-25%. Ngemuva kwe-eclampsia, cishe ingxenye yesine yokukhulelwa okuphindaphindiwe kuyinkimbinkimbi yi-preeclampsia, kepha amacala angu-2% kuphela aphinde ahlakulele i-eclampsia. Ngemuva kwe-pre-eclampsia, cishe u-15% uthuthukisa ukucindezeleka okungapheli phakathi neminyaka emibili ngemuva kokubeletha. Ngemuva kwe-eclampsia noma i-preeclampsia eqinile, imvamisa yayo i-30-50%.